Clinic signs v symptoms

[quattroboy]

OK, another question, as I travel my dry eye journey.

Just to say thank you to everyone who's spent the time replying to my queries and questions already.

My eyes seem to generate a white discharge despite achieving decent levels of comfort with my drops.

My left eye shows the most staining but seems the most comfortable symptom wise.

Also, I notice my nose seems a lot dryer since developing my dry eye.

My background is 8 months post LASIK but must have already started with dry eye. Found out I'm a partial blinker, lost nearly half my glands as a result. Oils seem good, Lippiflow did nothing for me.

Low tear volume now on steroids and ikervis.

Using a mask at night but I seem to sleep with my eyes close so not really helping much, but doesn't bother me, so will carry on.

Suffered from rhinitis before LASIK, not noticed much since dry eye.

[diydry]

People on this site definitely report strange relationships between something happening with the eyes and something happening elsewhere in the head, particular the nose and sinuses. When I had a lot of pressure in my ears and sinuses from a horrible infection, the anti-histamine medication i took relieved those symptoms well but caused my tear production to go to zero, so i had to stop. The point is that I’m not surprised you’re detecting changes in the nose but what it all means is beyond me.

[Guest]

There's a lot going on here too..let me see if I can get you thinking in the right direction. My eyes produce a lot of mucous too. It's because we don't have adequate tears for the mucus to mix with, so it accumulates in the corner of the eye. It's basically from having dry eyes.

If your nose nose is dry and it coincides with your eyes...could be so many things. Rather than speculate, I'd suggest you go get bloodwork to rule out hormonal issues and autoimmune issues. It's most likely not that, but at least you can rule of the big stuff and start narrowing down your possibilities.

If if I could suggest anything it would be to get a great doctor, get your glands images and expressed, get on serum tears because there's only upsides to taking it....this is a good place to start. I think you need someone who can diagnose your problems better.

[MGD1701]

Hi quattroboy

Low tear volume: How did your doctor detect that?

Plugs and serum tears can help with this issue.
But if you have inflammation then plugs are not a good idea.

[quattroboy]

There's a lot going on here too..let me see if I can get you thinking in the right direction. My eyes produce a lot of mucous too. It's because we don't have adequate tears for the mucus to mix with, so it accumulates in the corner of the eye. It's basically from having dry eyes.

If your nose nose is dry and it coincides with your eyes...could be so many things. Rather than speculate, I'd suggest you go get bloodwork to rule out hormonal issues and autoimmune issues. It's most likely not that, but at least you can rule of the big stuff and start narrowing down your possibilities.

If if I could suggest anything it would be to get a great doctor, get your glands images and expressed, get on serum tears because there's only upsides to taking it....this is a good place to start. I think you need someone who can diagnose your problems better.

Love to try serum drops but I'm UK based and their simply not an option. The UK doesn't have an independent compound pharmacies that can make them up, they're only available on the NHS but very very very difficult to get prescribed because of the cost.

Only realistic option is annemonic membrane to see if that can repair some of the LASIK damage.

Had a Lippiview which showed a lot of gland loss due to partial blinking. Glads aren't blocked and my oils are ok, but considering getting a seconds option.

My main issue is post LASIK decline in tear production and quality.

[Guest]

Love to try serum drops but I'm UK based and their simply not an option. The UK doesn't have an independent compound pharmacies that can make them up, they're only available on the NHS but very very very difficult to get prescribed because of the cost.

Only realistic option is annemonic membrane to see if that can repair some of the LASIK damage.

Had a Lippiview which showed a lot of gland loss due to partial blinking. Glads aren't blocked and my oils are ok, but considering getting a seconds option.

My main issue is post LASIK decline in tear production and quality.

That really sucks, the serum is pretty much the best option for healing your lasik induced dry eyes because I assume it's caused by nerve damage. If you can get the amniotic drops preservative free...do it.

[quattroboy]

That really sucks, the serum is pretty much the best option for healing your lasik induced dry eyes because I assume it's caused by nerve damage. If you can get the amniotic drops preservative free...do it.

Agreed there are loads of things in the States that just aren't options over here, both in terms of treatments and even choices of OTC drops! I even had to order by Eye Seals from the States!

It would be a annemonic membrane not drops, if I can get it done. Again it's a bit of a black art trying to access this type of treatment over here.

I count myself lucky I've been given the chance to try Ikervis.

[Guest]

Agreed there are loads of things in the States that just aren't options over here, both in terms of treatments and even choices of OTC drops! I even had to order by Eye Seals from the States!

It would be a annemonic membrane not drops, if I can get it done. Again it's a bit of a black art trying to access this type of treatment over here.

I count myself lucky I've been given the chance to try Ikervis.

I'm a pretty crazy guy, if you are anything like me, why don't you just buy the centerfuge, vials, eyedropers and saline just do it yourself? Clearly I'd prefer this done under a laminar flow hood but I saw a video of a guy that made his own serum. If you look on YouTube type in the search, autologous serum drops made. It's an older man in the thumbnail. He explains step by step how he makes them. I'm lucky my doctor makes mine in house...so I get my drops 30 mins after he draws my blood. If he were to retire or stop making them, I'd make them myself at home.

[quattroboy]

I'm a pretty crazy guy, if you are anything like me, why don't you just buy the centerfuge, vials, eyedropers and saline just do it yourself? Clearly I'd prefer this done under a laminar flow hood but I saw a video of a guy that made his own serum. If you look on YouTube type in the search, autologous serum drops made. It's an older man in the thumbnail. He explains step by step how he makes them. I'm lucky my doctor makes mine in house...so I get my drops 30 mins after he draws my blood. If he were to retire or stop making them, I'd make them myself at home.

Just seen it. I would be up for it but drawing the blood would be the issue. He still used his "friend" to draw the blood.

[deep_dry_eye]

I'm a pretty crazy guy, if you are anything like me, why don't you just buy the centerfuge, vials, eyedropers and saline just do it yourself? Clearly I'd prefer this done under a laminar flow hood but I saw a video of a guy that made his own serum. If you look on YouTube type in the search, autologous serum drops made. It's an older man in the thumbnail. He explains step by step how he makes them. I'm lucky my doctor makes mine in house...so I get my drops 30 mins after he draws my blood. If he were to retire or stop making them, I'd make them myself at home.

Interesting... my serum tears take like 3 hrs to make. The pharamcy lets the blood sits for awhile before they spin it, I forget the exact reason.

[diydry]

The serum tears issue is sort of annoying and complicated. As discussed in another thread, some locations prepare the drops in 1-2 hours (or less) while in other markets it can take over 30 days to prepare. We think we're getting the same product but from what I can tell, there are differences in the manufacturing process which may lead to different quality products. This is just to say that it would be great if there was some kind of standardization, regulation, and quality control of AST because it's sort of the Wild West right now... but the FDA does not get involved because it's not technically a pharmaceutical, for better or worse.

Quattroboy, are there any physicians in your area who do platelet-rich plasma injections? PRP injections are currently the big thing in pain management (typically for joint pain, knee pain etc) by orthopedic surgeons, psychiatrists, and others. Maybe ask one of these physicians if they'd be willing to make PRP drops for you. I am thinking about doing that with a local pain management physician once my current supply of AST is up.

If you're fed up with NIH, maybe take a trip to Washington or Boston and get the drops here (if you can afford the time and expense). You wouldn't be the first. You should be able to bring the drops back on the airplane in a cooler as long as you have the prescription. Or Spain. PRP is a growing treatment for dry eye in Spain and that's a lot closer to you.

[quattroboy]

The serum tears issue is sort of annoying and complicated. As discussed in another thread, some locations prepare the drops in 1-2 hours (or less) while in other markets it can take over 30 days to prepare. We think we're getting the same product but from what I can tell, there are differences in the manufacturing process which may lead to different quality products. This is just to say that it would be great if there was some kind of standardization, regulation, and quality control of AST because it's sort of the Wild West right now... but the FDA does not get involved because it's not technically a pharmaceutical, for better or worse.

Quattroboy, are there any physicians in your area who do platelet-rich plasma injections? PRP injections are currently the big thing in pain management (typically for joint pain, knee pain etc) by orthopedic surgeons, psychiatrists, and others. Maybe ask one of these physicians if they'd be willing to make PRP drops for you. I am thinking about doing that with a local pain management physician once my current supply of AST is up.

If you're fed up with NIH, maybe take a trip to Washington or Boston and get the drops here (if you can afford the time and expense). You wouldn't be the first. You should be able to bring the drops back on the airplane in a cooler as long as you have the prescription. Or Spain. PRP is a growing treatment for dry eye in Spain and that's a lot closer to you.

Ironically because, in the UK, only the National Blood Service can produce serum drops the quality would be first-rate, however, because only the National Blood Service can produce serum drops you can only get hold of them if your DES is very very serious, because funding for them would need to be agreed by the local health authority. Paying for them privately is not an option.

I know of a compound pharmacy in Spain that can do Serum Drops.

The membrane seems the most accessible treatment to start with, has all the right nutrients and human growth factors in it to kick-start the healing process. Well, that's the theory.

[Guest]

Ironically because, in the UK, only the National Blood Service can produce serum drops the quality would be first-rate, however, because only the National Blood Service can produce serum drops you can only get hold of them if your DES is very very serious, because funding for them would need to be agreed by the local health authority. Paying for them privately is not an option.

I know of a compound pharmacy in Spain that can do Serum Drops.

The membrane seems the most accessible treatment to start with, has all the right nutrients and human growth factors in it to kick-start the healing process. Well, that's the theory.

I'm not pushing the issue on you, just curious...do you think they would deem your eyes too healthy for the drops?

If you do the membrane i hope it works works out im very curious about it.

[quattroboy]

I'm not pushing the issue on you, just curious...do you think they would deem your eyes too healthy for the drops?.

Yes basically, my consultant reckons I'm moderate to severe. I would need to have tried everything else for 12 months and shown no improvement before even being considered.

And because I'm LASIK dry eye, they say it takes up to 12 months to get back to your original tear volumes. But I started with dry eye (which I didn't know until afterwards), so I'm pretty sure I'm stuck like this.

If you're interested page 26 onwards of this PDF outlines the criteria: https://www.rcophth.ac.uk/wp-content...-Guideline.pdf

The NHS's resources in the UK are stretched to near breaking point so dealing with dry eye is not really their top priority.

[Guest]

Yes basically, my consultant reckons I'm moderate to severe. I would need to have tried everything else for 12 months and shown no improvement before even being considered.

And because I'm LASIK dry eye, they say it takes up to 12 months to get back to your original tear volumes. But I started with dry eye (which I didn't know until afterwards), so I'm pretty sure I'm stuck like this.

If you're interested page 26 onwards of this PDF outlines the criteria: https://www.rcophth.ac.uk/wp-content...-Guideline.pdf

The NHS's resources in the UK are stretched to near breaking point so dealing with dry eye is not really their top priority.

This makes me angry and sad for you...you need these growth factors immediately. Even if they approved you, you have to fail for a year before they'd even consider doing the drops? Wow! Insane! I'm really sorry you're going through this.